Kebede decided no. And so he instead turned down 35 percent of the funding for his organization in 2001 by refusing to abide by the Global Gag Rule.

“We have to give full respect for women’s rights,” he said. “That’s what we had at the back of our minds when we rejected the conditions (of the Gag Rule).”

The Global Gag Rule denies foreign organizations receiving U.S. family planning assistance the right to use their own non-U.S. funds to provide information, referrals or services for legal abortion or advocate for it. President Obama rescinded the Gag Rule shortly after taking office, but now Republicans in the U.S. House of Representatives are trying to bring it back by slipping it into proposals to fund the government for the rest of 2011. The funding bill passed by the House on Feb. 19 included reinstatement of the Gag Rule. The Senate rejected that bill, but no funding deal has yet been reached and negotiations are ongoing.

If the Gag Rule is reinstated, organizations like FGAE that receive international family planning funding from the U.S. would be restricted from assisting a woman who wants an abortion, even if the abortion would be legal in their country. In the example of the scared young woman above, Kebede could provide abortion services under Ethiopia’s law, which allows abortions for young people unprepared to raise a child. But if FGAE accepted any family planning assistance from the U.S. government, he would be banned from providing those services, or even counseling the young woman about her options if she wasn’t sure what to do.

“If we don’t have access here, they will go for a backyard abortion,” Kebede said, referring to untrained providers in Ethiopia, where unsafe abortion is a leading cause of maternal death. “There is something that is lethal about the US government’s policies.”

The Gag Rule, formally known as the Mexico City Policy, was first imposed by the Reagan administration in 1984. It was rescinded in 1993 by President Clinton and then reinstated in 2001 by President Bush. When the Gag Rule was in effect, it hurt family planning organizations – both those that complied and those that didn’t – and impeded women’s access to health services.

In the case of FGAE, Ethiopia’s largest and oldest reproductive health organization, the price was steep. The loss of USAID financial support for family planning forced the Association to curtail services at clinics and lay off staff. They scaled back their community outreach program, which was the primary source of family planning and HIV/AIDS information and services for many people living in remote areas.

In addition to losing funding, FGAE lost access to USAID contraceptives. FGAE tried to compensate by getting assistance from European governments, but without USAID-donated contraceptives, they were unable to provide free condoms at their clinics due to recurring shortages. In 2003, FGAE’s branch office in Nazareth reported that they were about to run out of Depo-Provera, the birth control method used by 70 percent of their clients.

“Because of the policy direction of the US government, we were denied access to resources for 8 years,” Kebede said.

By hamstringing established reproductive health organizations like FGAE, the Gag Rule worsened a dire situation in Ethiopia where 1 in 150 women dies in pregnancy or childbirth and seven in 10 women who want to avoid pregnancy don’t have effective contraception. Furthermore, the Gag Rule does not reduce abortions – it impedes the very services that help women avoid unintended pregnancy.

If anti-family planning Members of Congress succeed in reinstating this policy, it will not reduce the deficit one penny. It will only undermine existing investments in family planning by forcing Kebede and other providers to choose between U.S. funding and serving the women that come to them for help.

“We pray for the permanent repeal of the Gag Rule,” Kebede said. “Otherwise…”

He shakes his head, knowing the choice he’d face again. Let’s not allow our politicians to force him to make that choice.